Reliability and validity of the 4-meter walk test in patients with multiple sclerosis.

BACKGROUND: Walking speed is considered a vital sign of health and better functional outcomes. It is important to assess walking speed both for disease monitoring and before starting rehabilitation. The aim of this study was to examine the reliability, validity, minimal detectable change, and the ideal cutoff time for differentiating patients with multiple sclerosis (PwMS) who fall from PwMS who do not. METHODS: This study included 43 PwMS (26 female and 17 male) and 36 healthy controls (23 female and 13 male). The 4-meter walk test (4-MWT) was conducted with the 10-meter walk test (10-MWT), timed up and go (TUG) test, dynamic gait index (DGI), timed 25-foot walk (T25-FW), multiple sclerosis walking scale-12 (MSWS-12), and the expanded disability status scale (EDSS). RESULTS: Excellent test-retest reliability (ICC = 0.971) was found for the 4-MWT. The SEM value was 0.38 and MDC value was 1.05. The correlations with 4-MWT, 10-MWT, TUG, DGI, T25-FW, MSWS-12, and EDSS were found to be statistically significant (p < 0.001). PwMS had longer 4-MWT times than healthy controls, and PwMS fallers had longer 4-MWT times than non-fallers with PwMS (r between 0.668 and -0.858; p < 0.05 for all). In order to distinguish fallers from non-fallers with PwMS, a 4-MWT cutoff time of 4.14 s was shown to be optimal. CONCLUSION: The 4-MWT was found to be valid and reliable for PwMS. It is concluded that the 4-MWT is a feasible assessment method for clinical and methodological studies of PwMS with mild to moderate disability.

Reference Values for 7 Different Protocols of Simple Functional Tests: A Multicenter Study.

OBJECTIVES: To establish reference values and equations (ages 20-80y) for 7 simple functional tests based on a multicenter study. DESIGN: Cross-sectional data collection in 4 research centers across different regions of a continental dimension country. SETTING: Healthy subjects from general community were assessed in different research laboratories. PARTICIPANTS: Data collection of 296 volunteer subjects (N=296; 45% men; aged 50±18y, forced expiratory volume in the first second 95±13% pred, body mass index 26.9±4.5 kg/m2) aged 20-80 years; representing both sexes; with the ability to understand and perform all proposed assessments; and with no severe and/or unstable condition that could limit functional assessments occurred simultaneously in all centers. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: All participants randomly performed the following 7 functional tests twice: (1) the 4-meter gait speed test at usual walking speed; (2) the 4-meter gait speed test at maximal walking speed; (3) the Sit-to-Stand test performed with 5 repetitions; (4) the Sit-to-Stand test performed in 30 seconds; (5) the Sit-to-Stand test performed in 1 minute; (6) the Timed Up and Go test at usual speed; and (7) the Timed Up and Go test at maximal speed. Spirometry, quality of life, depression, anxiety, physical activity, and comorbidities were also assessed to better characterize the sample. The best performance of each test was used to propose reference values for men and women and reference equations for all. RESULTS: Participants similarly distributed by age groups from the 4 centers were included. All tests were correlated with age (0.34

Experiences of Physical Therapists and Professional Leaders With Implementing a Toolkit to Advance Walking Assessment Poststroke: A Realist Evaluation.

OBJECTIVE: The iWalk study showed significant increase in use of the 10-Meter Walk Test (10MWT) and 6-Minute Walk Test (6MWT) poststroke following provision of a toolkit. This paper examined the influence of contextual circumstances on use of the toolkit and implementation strategy across acute care and inpatient and outpatient rehabilitation settings. METHODS: A theory-based toolkit and implementation strategy was designed to support guideline recommendations to use standardized tools for evaluation of walking, education, and goal-setting poststroke. The toolkit comprised a mobile app, video, and educational guide outlining instructions for 3 learning sessions. After completing learning sessions, 33 physical therapists and 7 professional leaders participated in focus groups or interviews. As part of a realist evaluation, the study compared and synthesized site-specific context-mechanism-outcome descriptions across sites to refine an initial theory of how the toolkit would influence practice. RESULTS: Analysis revealed 3 context-mechanism-outcomes: (1) No onsite facilitator? No practice change in acute care: Without an onsite facilitator, participants lacked authority to facilitate and coordinate the implementation strategy; (2) Onsite facilitation fostered integration of select practices in acute care: When onsite facilitation occurred in acute care, walk test administration and use of reference values for patient education were adopted variably with high functioning patients; (3) Onsite facilitation fostered integration of most practices in rehabilitation settings: When onsite facilitation occurred, many participants incorporated 1 or both tests to evaluate and monitor walking capacity, and reference values were applied for inpatient and outpatient education and goal setting. Participants preferentially implemented the 10MWT over the 6MWT because set-up and administration were easier and a greater proportion of patients could walk 10 m. CONCLUSION: Findings underscore contextual factors and activities essential to eliciting change in assessment practice in stroke rehabilitation across care settings. IMPACT: This study shows that to foster recommended walking assessment practices, an onsite facilitator should be present to enable learning sessions and toolkit use.

Normative data for the 6-min walk test in 11-14 year-olds: a population-based study.

BACKGROUND: The 6-min walk test (6MWT) has become an established measure for assessing exercise capacity in children with chronic diseases. However, little evidence has been provided regarding population-based normal data in healthy children. The main purpose of the study was to provide normative data in a large sample of children. METHODS: In this cross-sectional study, 4352 children between 11 and 14 years were recruited (66% girls). The main outcome measure was the distance walked for six minutes. Sex- and age-specific percentile values (5th, 15th, 25th, 50th, 75th, 85th and 95th) for the 6MWT were created and the differences and correlations were examined by the analysis of variance and Pearson's coefficient of correlation. RESULTS: The mean distance walked in 6 min was 576 ± 93 m in boys and 545 ± 92 m in girls, respectively. The mean walking speed for boys and girls was 98 ± 5 m/min and 91 ± 6 m/min. Older boys and girls performed better, compared to their younger counterparts (p for age < 0.001). The 6MWT was significantly correlated with age (r = 0.24, p < 0.001), height (r = 0.09, p < 0.001), weight (r = - 0.13, p < 0.001) and body-mass index (r = - 0.26, p < 0.001). CONCLUSIONS: This is the first population-based study aiming to provide normative data for the 6MWT in healthy children between 11 to 14 years. Children in lower percentiles are 'target groups' for special intervention aiming to enhance the performance.

Distance-limited walk tests post-stroke: A systematic review of measurement properties.

BACKGROUND: Improving walking capacity is a key objective of post-stroke rehabilitation. Evidence describing the quality and protocols of standardized tools for assessing walking capacity can facilitate their implementation. OBJECTIVE: To synthesize existing literature describing test protocols and measurement properties of distance-limited walk tests in people post-stroke. METHODS: Electronic database searches were completed in 2017. Records were screened and appraised for quality. RESULTS: Data were extracted from 43 eligible articles. Among the 12 walk tests identified, the 10-metre walk test (10mWT) at a comfortable pace was most commonly evaluated. Sixty-three unique protocols at comfortable and fast paces were identified. Walking pace and walkway surface, but not walkway length, influenced walking speed. Intraclass correlation coefficients for test-retest reliability ranged from 0.80-0.99 across walk tests. Measurement error values ranged from 0.04-0.40 and 0.06 to 0.20 for the 10mWT at comfortable and fast and paces, respectively. Across walk tests, performance was most frequently correlated with measures of strength, balance, and physical activity (r = 0.26-0.8, p < 0.05). CONCLUSIONS: The 10mWT has the most evidence of reliability and validity. Findings indicate that studies that include people with severe walking deficits, in acute and subacute phases of recovery, with improved quality of reporting, are needed.

Cognitive Processing Speed Impairment Does Not Influence the Construct Validity of Six-Spot Step Test Performance in People With Multiple Sclerosis.

OBJECTIVE: There is evidence supporting the construct validity of Six-Spot Step Test (SSST) performance as a functional mobility measure in people with multiple sclerosis (MS); however, it is unknown if cognitive processing speed impairment confounds the construct validity of SSST performance in MS, as this test seemingly requires intact cognitive processing. The objective of this study was to examine the influence of cognitive processing speed impairment on the construct validity and precision of SSST performance as a functional mobility measure in MS. METHODS: Participants (N = 213) completed the SSST, timed 25-foot walk, 6-Minute Walk Test, Timed "Up and Go" Test, Multiple Sclerosis Walking Scale-12, device-measured steps per day, and Late-Life Function and Disability Inventory, Patient-Determined Disease Steps, and the Symbol-Digit Modalities Test as a cognitive processing speed measure. The overall sample was divided into subsamples with (n = 75) and without (n = 138) cognitive processing speed impairment based on normative Symbol-Digit Modalities Test data. Correlations between SSST performance with other mobility outcomes in the overall sample and cognitive processing speed impairment subsamples were examined and compared. SSST performance was compared relative to other mobility measures for differentiating MS walking function levels in people with and without cognitive processing speed impairment. RESULTS: SSST performance was significantly and strongly correlated with most mobility outcomes in the overall sample and cognitive processing speed impairment subsamples. The magnitudes of correlations between SSST performance with most mobility outcomes were not statistically different among subsamples. Cognitive processing speed impairment did not diminish the relative precision of SSST performance for differentiating walking function levels. CONCLUSION: The presence of cognitive processing speed impairment is not a source of invalidity or imprecision when interpreting SSST performance as a functional mobility measure among people with MS. IMPACT: The SSST is a high-quality endpoint for inclusion in interventions targeting mobility in MS, regardless of cognitive processing speed status. This information is critical for rehabilitation research and clinical practice given that mobility and cognitive impairment are highly prevalent, co-occurring, and disabling in MS.

Reference Centiles to Monitor the 6-minute-walk Test in Ambulant Children with Cerebral Palsy and Identification of Effects after Rehabilitation Utilizing Whole-body Vibration.

Background: Children with cerebral palsy present age-driven development in gross motor skills and walking capacity. Aims: To precisely monitor the 6-minute walk test (6MWT) in children with CP, GMFCS levels 1 and 2 over 6 months and to assess the effect of a 6-month rehabilitation program including whole-body vibration. Methods: Retrospective analysis of data of 157 children with CP who received standardized rehabilitation (DRKS00011331). 6MWT was assessed at the start (M0) and end of the training (M6), as well as at a 6-month follow-up (M12). Centiles were created using the lambda-mu-sigma (LMS) method. Results: We created 6MWT percentiles using data of all 157 children (M0 data). A medium treatment effect size (Cohen's d = 0.69) was found (M6 and M12 data). Conclusions: The generated centiles may help monitor 6MWT changes over 6 months. Combining WBV and conventional physiotherapy can significantly improve 6MWT in children with CP. Abbreviations: 6MWT: 6-Minute Walk Test; CP: Cerebral palsy; ES: effect size; GMFCS: Gross Motor Function Classification System; GMFM-66: Gross Motor Function Measure 66; LOESS: locally weighted scatterplot smoothing; LMS: lambda-mu-sigma; MCID: minimal clinical important difference; SD: standard deviation; SRM: standardized response mean; WBV: whole-body vibration.

A performance comparison of the 20 and 30 meter six-minute walk tests among middle aged and older adults.

Objective: To compare the performance of the Six-Minute Walk Test on 20-meter (6MWT20) and 30-meter (6MWT30) tracks and to test the validity and reliability of the 6MWT20 in middle-aged and older adults.Method: The subjects underwent lung function assessment and performed the 6MWT30 and 6MWT20. Student´s t-tests or Wilcoxon tests were used to compare the variables. The Pearson or Spearman correlation coefficients were used to evaluate the validity of the 6MWT20 and the reliability of the 6MWT20. The 6MWT30 was tested by the two-way mixed model of the Intraclass Correlation Coefficient (ICC 3,1).Results: Twenty-five subjects (age: 60 ± 10 years) walked, on average, 11.0 ± 21.9 m more in the 6MWT30 than in the 6MWT20 (p < .05). The walking distance, the number of steps, the energy expenditure and the movement intensity between the 6MWT20 and 6MWT30 was correlated (r = 0.95; r = 0.81; r = 0.91; r = 0.67; respectively, p < .001). The walking distances showed high reliability and were similar between test and re-test in the 6MWT30 (544 ± 72.1 vs. 551 ± 70.5; p < .05; ICC = 0.97) and in the 6MWT20 (533 ± 73.1 vs. 532 ± 59.1; p < .05; ICC = 0.87).Conclusion: The 6MWT20 performance is lower than the 6MWT30 However, this difference is not clinically relevant. Additionally, the 6MWT20 is a valid and reproducible test to assess the functional capacity of middle-aged and older adults.

Development, Validity, and Reliability of a Novel Walking Speed Measurement Device: the GaitBox.

BACKGROUND: Gait speed is an important measure of health status for older adults and individuals with neurological conditions. Literature reports that measurements made by people are not as accurate as automatic timers. RESEARCH QUESTION: Is the GaitBox (GB), a device to measure walking speed (WS) automatically and accurately, a valid approach to walking speed measurement in a clinical setting? METHODS: Two prospective validation studies were completed comparing the GB to human timers (HT) and the Sprint Timing System (STS). Subjects were recruited from convenience samples of healthy older adults (S1, N = 35, 72.4 + 7.4 years of age) and individuals with Spinal Cord Injury (SCI), Traumatic Brain Injury (TBI), or unknown / no diagnosis (S2, N = 44, 35.3 + 13.5 years of age). Subjects completed 4 timed walks. The GB, HT, and STS simultaneously measured WS across a 4 m or 10 m course. Protocol followed an adapted version of the NIH Walk Test. Subjects were instructed to walk at a normal pace. Validity and reliability were determined using Pearson correlations, absolute mean differences, Intraclass Correlation Coefficients (ICC's) and Bland-Altman plots. RESULTS: WS measured in both studies demonstrated strong correlations between GB and STS (r = 0.98-0.99, p < 0.0001), excellent test-retest reliability GB ICC's (0.93-0.94), no systematic bias, and good precision. In S1 and S2, ICC's between GB and STS were excellent at 0.91 and 0.93, respectively. SIGNIFICANCE: Considering the increased use of WS as a clinically relevant measure of mobility, functional decline, and recovery, accurate measurement of WS are important. These studies show the GB is a valid and reliable measurement tool within various populations completing the 4 m and 10 m walk tests at a usual speed. Additional populations and walking distances should be evaluated further. Due to its accuracy, the GaitBox is a valid alternative to HT in the clinic setting.

Validity of the Mini-BESTest in adults with myotonic dystrophy type 1.

INTRODUCTION: Myotonic dystrophy type 1 (DM1) is a multisystemic neuromuscular disease that causes balance problems. The objective of this study was to assess the construct validity of the Mini-BESTest among adults with DM1. METHODS: Fifty-nine individuals with late-onset or adult phenotypes of DM1 were recruited. Participants performed the Mini-BESTest, 10-Meter Walk Test (10mWT), 6-Minute Walk Test (6MWT), and Timed Up & Go (TUG) and were questioned on their tendency to lose balance and whether they fell in the past month. RESULTS: Scores on the Mini-BESTest were significantly different between phenotypes and CTG repeat numbers (P < .02). Significant correlations were found with the 10mWT, 6MWT, and the TUG (r = 0.77-0.84; P < .001). A cutoff score of 21.5 was found to identify fallers with 90% posttest accuracy. DISCUSSION: The Mini-BESTest demonstrates evidence of construct validity when assessing balance in the DM1 population.

Development and Validation of Person-Centered Cut-Points for the Figure-of-8-Walk Test of Mobility in Community-Dwelling Older Adults.

BACKGROUND: The Figure-of-8-Walk test (F8WT) is a performance measure of the motor skill of walking. Unlike walking speed over a straight path, it captures curved path walking, which is essential to real-world activity, but meaningful cut-points have yet to be developed for the F8WT. METHODS: A secondary analysis of 421 community-dwelling older adults (mean age 80.7 ± 7.8), who participated in a community-based exercise clinical trial, was performed. Area under receiver operating characteristic curves (AUROCC) were calculated using baseline data, with F8WT performance discriminating different self-reported global mobility and balance dichotomies. Cut-points for the F8WT were chosen to optimize sensitivity and specificity. For validation, F8WT cut-points were applied to postintervention F8WT data. Participants were called monthly for 12 months after intervention completion to record self-reported incident falls, emergency department visits, and hospitalizations; risks of the outcomes were compared between those who performed well and poorly on the F8WT. RESULTS: F8WT performance times of ≤9.09 seconds and ≤9.27 seconds can discriminate those with excellent (sensitivity = 0.647; specificity = 0.654) and excellent/very good global mobility (sensitivity = 0.649; specificity = 0.648), respectively. A total number of steps ≤17 on the F8WT can discriminate those with excellent/very good/good global balance (sensitivity = 0.646; specificity = 0.608). Compared to those who performed poorly, those who performed well had a lower incidence of negative outcomes: F8WT time ≤9.09 seconds = 46%-59% lower; F8WT time ≤9.27 seconds = 46%-56% lower; F8WT steps ≤17 = 44%-50% lower. CONCLUSIONS: Clinicians may consider these preliminary cut-points to aid in their clinical decision making, but further study is needed for definitive recommendations.

Limitations of 6-minute walk test reference values for spinal muscular atrophy.

INTRODUCTION: The 6-minute walk test (6MWT) is a well-established clinical assessment of functional endurance, validated as a measure of walking ability in spinal muscular atrophy (SMA). The current availability of disease-modifying therapies for SMA indicates a growing need for normative reference data to compare SMA patients with healthy controls. METHODS: The literature was searched in two scientific databases. Studies were evaluated and selected based on adherence to American Thoracic Society guidelines for administering the 6MWT. Reference equations from the selected studies were applied to 6MWT data collected from SMA patients to calculate and compare % predicted values. RESULTS: Three pediatric and six adult studies were selected for comparison. The % predicted values using the pediatric and adult equations ranged from 47.7 ± 18.2% to 67.6 ± 26.2% and 43.0 ± 17.9% to 59.5 ± 26.2%, respectively, and were significantly different (P < 0.001). DISCUSSION: Results suggest significant variability between % predicted values derived from published reference equations in children and adults, despite adherence to 6MWT standardization.

Concurrent validity of the Groningen Meander Walking and Timed Up and Go tests in older adults with dementia.

Background and Purpose: The Groningen Meander Walking time (GMW-sec) test has not been clinically validated as a feasible assessment to test functional mobility skills. The purpose of this study was to determine the concurrent validity of the GMW-sec test with the Timed Up and Go (TUG) test in older adults with dementia. Methods: This study included a cross-sectional and between subjects design with one factor, which had three different levels of group. Consecutive sampling was used to recruit 145 elderly participants in dementia and senior care facilities. Participants were divided into three groups based on the result of a Mini-Mental Status Exam for Dementia Screening: 57 older adults with dementia, 25 older adults with mild cognitive impairment, and 63 healthy older adults. Results: Spearman rank order correlation showed that the TUG test had moderate association with the GMW-sec test not only in older adults with dementia (r = 0.69; p < 0.01), but also for the mild cognitive group (r = 0.63; p = 0.01) and healthy group (r = 0.47; p < 0.01). Older adults with dementia had a significant functional reduction for both GMW-sec and TUG tests compared to other two groups (p < 0.01). Discussion and Conclusion: Turning motions with the TUG test may cause similar challenges that relate to a curved walking path for the GMW-sec test in older adults with dementia. Both the TUG and GMW-sec tests could be effective approaches for screening the severity of cognitive impairment on functional mobility in people with dementia.

One-Minute Walk Test in Children with Cerebral Palsy GMFCS Level 1 and 2: Reference Values to Identify Therapeutic Effects after Rehabilitation.

Background: Children with cerebral palsy (CP) show age-driven development and individual fluctuations in walking capacity.Aim: 1. To precisely quantify 1MWT changes in children with CP, GMFCS level 1 and 2, generating 1MWT percentiles, depicting expected development over 6 months; 2. to assess the effect of a 6-month rehabilitation using whole-body vibration (WBV).Methods: Retrospective data analysis in 210 children with CP, GMFCS 1 and 2 who received standardized rehabilitation (DRKS00011331). 1MWT was assessed before (M0) and after treatment (M6), and at a 6-month follow-up (M12). Centiles were created using the lambda-mu-sigma method. Cohen's d was used to assess effect size.Results: We created 1MWT percentiles using data of all 210 children (M0 data). A small treatment effect size (d = 0.46) was found (M6 and M12 data).Conclusions: Using the generated centiles clinicians may monitor 1MWT changes over 6 months. Combining WBV and conventional physiotherapy may improve 1MWT in children with CP.Abbreviations: 1MWT: One-Minute Walk Test; 6MWT: Six-Minute Walk Test; CP: Cerebral palsy; ES: effect size; GMFCS: Gross Motor Function Classification System; GMFM-66: Gross Motor Function Measure 66; LOESS: Locally Estimated Scatterplot Smoothing; LMS: lambda-mu-sigma; SD: standard deviation; WBV: whole-body-vibration.

Reliability, validity and minimal detectable change of 2-min walk test and 10-m walk test in frail older adults receiving day care and residential care.

BACKGROUND: The psychometric properties of the 2-min walk test (2MWT) and 10-m walk test (10MeWT) for frail older adults are unclear. AIMS: To determine the test-retest and inter-rater reliability, construct and known-group validity, and minimal detectable change at 95% level of confidence (MDC95) of these walk tests in frail older adults receiving day care and residential care services. METHODS: A cross-sectional study with repeated measures was conducted on frail older adults who could walk independently for at least 15 m. The participants completed the 2MWT and 10MeWT on three separate occasions over a 2-week period under two independent assessors. RESULTS: Forty-four frail older adults were examined. Excellent test-rest (ICC = 0.95-0.99) and inter-rater reliability (ICC = 0.95-0.97) were shown in both walk tests. Good to strong correlations were found between the walk tests and 6-min walk test (r = 0.89-0.92), Elderly Mobility Scale (r = 0.56-0.57), Berg Balance Scale (r = 0.66-0.66) and Modified Barthel Index (r = 0.55-0.59). The MDC95 were 7.7 m in the 2MWT and 0.13 m/s in the 10MeWT. DISCUSSION: Although the walking performances of the day care and residential care participants were similar, the validity of the walk tests was different between these two subgroups. CONCLUSIONS: The 2MWT and 10MeWT are reliable and valid measures in evaluating the walking performances of frail older adults. The MDC95 of the walk tests has been recommended.

Reference value of 6-minute walk distance in patients with sub-acute stroke.

BACKGROUND: The 6-minute walk test (6MWT) has strong-to-moderate evidence to assess changes in walking distance for adults with neurologic conditions undergoing rehabilitation. However, the reference value of 6MWT distance according to walking ability and the cutoff value of walking independence in stroke patients in the rehabilitation unit has not been presented. OBJECTIVES: To present the reference value of 6MWT distance depending on walking ability and determine the cutoff value of walking independence in stroke patients. METHODS: This cross-sectional observational study included 110 stroke patients admitted to the rehabilitation unit within 30 days from stroke onset. 6MWT was used to assess the walking ability at 30 days from stroke onset. Walking ability was classified using the Functional Ambulation Category (FAC). Reference value of 6MWT distance was presented for each walking ability according to FAC score. One-way analysis of variance was computed to investigate 6MWT distance according to walking ability. Receiver operating characteristic curve was used to identify the cutoff value of 6MWT for walking independence. RESULTS: 6MWT distances for each walking ability were as follows: FAC 2 was 141.8 m, FAC 3 was 224.5 m, FAC 4 was 352.6 m, and FAC 5 was 448.8 m (p < .001). Cutoff value of 6MWT for walking independence was 304 m (area under curve = 0.905, sensitivity of 0.833, specificity of 0.900). CONCLUSION: 6MWT distance was found to be longer with better walking ability. A distance of 304 m during 6MWT might be useful for judging walking independence in stroke patients.

Validation of stroke-specific protocols for the 10-meter walk test and 6-minute walk test conducted using 15-meter and 30-meter walkways.

Background: Stroke-specific protocols for the 10-meter and 6-minute walk tests that include instructions for people with aphasia, accessible walkway lengths, and allow provision of assistance to walk are needed to facilitate uptake in hospital settings.Objectives: To estimate the test-retest reliability, measurement error, and construct validity of stroke-specific protocols for the 10-meter walk test (10mWT), and 6-minute walk test conducted using a 15-meter walkway (6MWT15m) and 30-meter walkway (6MWT30m), in people post-stroke.Methods: A quantitative, cross-sectional study involving ambulatory people post-stroke was conducted.Results: Data were collected from 21 and 20 participants at baseline and retest, respectively, 1-3 days apart. Mean age was 61 years, median time post-stroke was 134 days, and 90% had experienced an ischemic stroke. Performance on the 10mWT, 6MWT15m, and 6MWT30m across sessions yielded intraclass correlation coefficient (ICC2, 1) estimates of test-retest reliability of 0.83, 0.97, 0.95, respectively, and minimal detectable change values at the 95% confidence level of 0.40m/s, 44.0m, and 67.5m, respectively. Pearson correlation coefficients were 0.80-0.95 (p < .001) between results on all three walk tests and 0.27-0.48 (p < .25) between walk test results and strength subscale scores on the Stroke Impact Scale.Conclusions: Findings showed excellent test-retest reliability; measurement error values similar to current literature; and support for construct validity of the 10mWT, 6MWT15m, and 6MWT30m. Due to the shorter walkway, the 6MWT15m may be more feasible to implement than the 6MWT30m in hospital settings. A larger sample with more severe deficits is required to improve generalizability.

Test-retest reliability, validity, and correlates of the 2-min walk test in outpatients with depression.

OBJECTIVES: A reason for the lack of interest in physical fitness testing in mental healthcare is limited time among existing staff. This cross-sectional study investigated the test-retest reliability of the 2-min walk test (2MWT) and its concurrent validity with the 6-min walk test (6MWT) in Ugandan patients with depression. We also explored practice effects and assessed the minimal detectable change (MDC) and clinical correlates with the 2MWT. METHODS: This is a cross-sectional study executed in Butabika National Referral Hospital in Kampala, Uganda. Fifty Ugandan patients with depression (15 women; median age = 29.0 years) performed twice a 2MWT, once a 6MWT, and completed the Simple Physical Activity Questionnaire (SIMPAQ), and Brief Symptoms Inventory-18 (BSI-18). RESULTS: The median (interquartile) 2MWT score on the first and second test were 125.5 (59.2) meters and 131.0 (57.0) meters (p = .28). The intraclass correlation was.96 (95% confidence interval [0.94, 0.98]). The MDC was 23.5 m for men and 23.4 m for women. There was no evidence of a practice effect. Scores on BSI-18 depression, SIMPAQ walking, and SIMPAQ incidental physical activity explained 66.3% of 2MWT score variance. CONCLUSION: The 2MWT is a reliable test, which can be conducted without any special equipment or substantial time demands, to provide a valid assessment of the functional exercise capacity in outpatients with depression.

Extended steep ramp test normative values for 19-24-year-old healthy active young adults.

PURPOSE: To extend currently available sex and age-specific normative values in children and adolescents for the peak work rate (WRpeak) attained at the steep ramp test (SRT) to healthy active young adults. METHODS: Healthy male and female participants aged between 19 and 24 years were recruited. After screening and anthropometric measurements, participants performed a SRT on a cycle ergometer (increments of 25 W/10 s), monitoring and recording SRT-WRpeak, heart rate (HR), and blood pressure (BP) at rest and directly after peak exercise. RESULTS: Fifty-seven participants (31 males and 26 females; median age of 21.3 years) volunteered and were tested. Anthropometrics, resting BP and lung function were all within normal ranges. Ninety-three percent of the participants attained a peak HR (HRpeak) > 80% of predicted (mean HRpeak 87 ± 5% of predicted). No differences were found in resting and peak exercise variables between females and males, except for absolute SRT-WRpeak (350 W [Q1: 306; Q3: 371] and 487 W [Q1: 450; Q3: 517], respectively) and SRT-WRpeak normalized for body mass (relative SRT-WRpeak; 5.4 ± 0.5 and 6.2 ± 0.6 W/kg, respectively). Low-to-moderate correlations (ρ [0.02-0.71]) were observed between SRT-WRpeak and anthropometric variables for females and males separately. Extended reference curves (8-24-year-old subjects) for SRT performance show different trends between male and female subjects when modelled against age, body height, and body mass. CONCLUSIONS: The present study provides sex-, age-, body height-, and body mass-related normative values (presented as reference centiles) for absolute and relative SRT performance throughout childhood and early adulthood.